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Adopt and present a resolution recognizing November 2018 as Prematurity Awareness Month (Supervisor Hannigan)
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Published Notice Required? Yes ___ No _X_
Public Hearing Required? Yes ___ No _X _
DEPARTMENTAL RECOMMENDATION:
The Department of Health & Social Services (H&SS) recommends that the Board of Supervisors adopt and present a resolution recognizing November 2018 as Prematurity Awareness Month.
SUMMARY:
The Centers for Disease Control & Prevention (CDC), the California Department of Public Health (CDPH), and March of Dimes recognize November 2018 as Prematurity Awareness Month and November 17th as World Prematurity Day. H&SS, Public Health Division, Maternal, Child and Adolescent Health Bureau (MCAH) join these organizations in recognizing November as Prematurity Awareness Month to increase public awareness regarding the impact of premature births and steps Solano County residents can take to reduce risk. This resolution acknowledges the commitment to reduce rates of premature births and the need to follow recommendations for healthy pregnancies to promote and protect the health of women, infants, and their families.
FINANCIAL IMPACT:
The staff time associated with planning Prematurity Awareness activities is included in the department’s FY2018/19 Adopted Budget. The costs associated with preparing the agenda item are nominal and absorbed by the department’s FY2018/19 Adopted Budget. The costs associated with preparation and purchase of the resolution materials are included in the Board’s FY2018/19 Adopted Budget. There is no additional impact to the County General Fund.
DISCUSSION:
During the month of November, H&SS, Public Health Division, Maternal Child & Adolescent Health Bureau sponsors activities in Solano County to promote awareness and prevention of premature births. Together with the CDC and CDPH, the H&SS, Public Health Division, MCAH Bureau recognizes that prematurity should be addressed as a significant public health issue.
Prematurity, also referred to as preterm or premature birth, is defined as the live birth of a baby before 37 weeks of pregnancy. While preterm labor and delivery can happen to any pregnant woman, lifestyle and environmental factors, as well as certain health issues may increase a woman’s risk for preterm labor. Risk factors for preterm birth include late or no prenatal care, pregnancy with multiple babies, certain uterine or cervical abnormalities, prior preterm delivery, diabetes, high blood pressure or other health issues, lack of social support, toxic stress, long hours of work with prolonged periods of standing, and smoking, drinking or using drugs.
Complications from preterm birth are the number one cause of death for babies in the United States. Babies who survive premature birth often have long-term health problems, including cerebral palsy, intellectual disabilities, chronic lung disease, blindness and hearing loss. National data for 2017 is not yet available. However, in 2016, the United States experienced an increase in prematurity rates for the second consecutive year after a steady decline over the previous 7 years. More than 380,000, about 9.8 % of babies born in the U.S. each year, deliver before 37 weeks. This means 1 in 10 babies is born too soon. The U.S. preterm birth rate is among the worst of high-resource nations. The March of Dimes Premature Birth Report Card reveals racial/ethnic and geographic disparities signifying that babies have a higher chance of a premature birth based simply on race/ethnicity and zip code. In 2017, Solano County had 5,114 total births, and 424 or 8.3% were born premature. This rate is down from 8.6% in 2016.
Consequences of prematurity can be deep and long-lasting for babies, their families, and society. Babies born too early may have more health problems or may need to stay in the hospital longer than full-term babies.
Long-term health problems due to prematurity can have long-lasting financial effects and can impact a person’s education and ability to work. In 2007, the Institute of Medicine reported that the cost associated with premature birth in the United States was $26.2 billion each year. This amount included medical and health care costs for the baby; labor and delivery costs for the mother; early intervention services that help children birth to age three with disabilities and developmental delays; special education services for children ages three through twenty-one with disabilities that help with development and learning; and lost work and pay for people born prematurely. The cost amounts to approximately $51,600 per preterm infant.
There are significant disparities in rates of preterm birth among race and ethnic groups nationally and locally. Specific causes for this disparity are not completely understood, yet accounting for known risk factors, preterm rate disparities between White and Black infants persist. This difference in prematurity rates contributes to a higher Black infant mortality rate. In Solano County, the Black prematurity rate between 2014 and 2016 was 10.2%, almost 38% higher than the White rate of 7.4%. The Asian rate was 8.8% and Hispanic rate was 7.7%. Between 2006 and 2017, Solano County reduced the percentage of all infants born prematurely from 11.8% in 2006 to 8.3% in 2017. Comparative rates continue to be relatively high for Black infants in Solano County at 10.4% for 2017. Solano County has also seen improvements in rates of women entering prenatal care in the first trimester of pregnancy, from 71.3% in 2006 entering early prenatal care to 80.9% in 2017. Moreover, Solano County has been successful at improving rates of early entry to prenatal care for women with Medi-Cal, from 49.8% entering early prenatal care in 2006 to 71.6% in 2017.
H&SS, Public Health Division, MCAH Bureau and other community partners have consistently worked to improve birth outcomes for infants in Solano County, including reducing the number of premature births. Ongoing initiatives and programs working to improve birth outcomes and reduce rates of prematurity in Solano County include the Comprehensive Perinatal Services Program, Solano HEALS (Health Equity for African American/Black Lives), Nurse Family Partnership, Healthy Families Solano, Black Infant Health, and District Nursing. Each of these programs encourages women to seek early prenatal care and address barriers to accessing care.
In November, H&SS’s MCAH Bureau will continue to encourage all women to see a prenatal care provider within the first three months of their pregnancy to give their baby a healthy start. MCAH Bureau provides information about the importance of early prenatal care through social media, at local health fairs and community events, and to a variety of community agencies. The MCAH Bureau also works with pregnancy test providers and prenatal care providers to eliminate barriers to care at the individual and systems level.
ALTERNATIVES:
The Board could choose not to declare November 2017 as Prematurity Awareness Month in Solano County. This is not recommended as this resolution encourages and supports awareness of the availability and need for education, research and risk-reduction activities related to prematurity prevention.
OTHER AGENCY INVOLVEMENT:
Partner agencies joining H&SS, Public Health Division, MCAH Bureau in efforts to prevent premature birth include Solano County prenatal care providers participating in the Comprehensive Perinatal Services Program, Partnership HealthPlan of California, and Solano Home Visiting Community Advisory Board. The MCAH Bureau also co-leads a community collaborative called Solano HEALS, which aims to reduce rates of prematurity and low birth weight among Black infants. Solano HEALS partners include Kaiser Permanente, La Clínica Great Beginnings, Planned Parenthood, and the March of Dimes.
CAO RECOMMENDATION:
APPROVE DEPARTMENTAL RECOMMENDATION